Individual provider Active NPI

Jomana Shayota Kammo, DDS

  • General Practice Dentistry
  • Bingham Farms, MI
National Provider Identifier
1003334046
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901022363 Issued in MI
Practice address
30752 Telegraph Rd Ste B
Bingham Farms, MI 48025-4523
Phone
(248) 973-8102
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901022363 MI Primary

Addresses

Primary practice location

30752 Telegraph Rd Ste B
Bingham Farms, MI 48025-4523

Mailing address

30752 Telegraph Rd Ste B
Bingham Farms, MI 48025-4523
Phone (248) 973-8102

Other identifiers 1

IdentifierTypeStateIssuer
1306583943MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901022363MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jomana S Shayota General Practice CurrentSince Jun 18, 2023 Accepting new patients
Chelsea Family Dentistry PLC General Practice PastSince Jul 1, 2022 Accepting new patients

Locations

32749 Franklin Rd
Ste 200
Franklin, MI 48025
Phone (248) 973-8102

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1003334046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30752 TELEGRAPH RD STE B",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254523",
            "telephone_number": "248-973-8102",
            "fax_number": "248-973-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30752 TELEGRAPH RD STE B",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254523",
            "telephone_number": "248-973-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMO",
        "first_name": "JOMANA",
        "middle_name": "SHAYOTA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306583943",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.